Intelligent selection system for electrosurgical instrument

ABSTRACT

An intelligent selection system for operating an electrosurgical instrument for use by a surgeon that depends primarily on the surgical procedure to be employed. The operating mode as well as other operating parameters can be controlled by the handpiece chosen by the surgeon to perform the procedure. Each handpiece is customized to activate when operated one of several preset operating modes of the electrosurgical instrument.

[0001] This invention is based on a Disclosure Document filed in theU.S. Patent And Trademark office on Jun. 6, 2001 and entitledINTELLIGENT SELECTION SYSTEM FOR ELECTROSURGICAL INSTRUMENT.

[0002] The invention is directed to an electrosurgical instrument, andin particular to an intelligent selection system and a handpiece for usein such a system for controlling an electrosurgical instrument orapparatus.

BACKGROUND OF INVENTION

[0003] Electrosurgical instruments are well known and widely used in themedical, dental, and veterinarian fields. They offer the capability ofprecision cutting and coagulation with electrosurgical currentspreferably in the megacycle range using a handpiece with, for example,needle, ball, or loop electrodes in a unipolar operating mode or with aforceps in a bipolar operating mode. Ellman International, Inc. makesavailable an electrosurgical instrument for Radiosurgery which provideson its front panel connectors for receiving the plug of acable-connected unipolar handpiece and a ground or indifferent plate, aswell as connectors for receiving the plug of a cable-connected bipolarelectrode. One form of such an instrument is described in U.S. Pat. No.5,954,686, whose contents are incorporated herein by reference. Suchinstruments are characterized by different modes and sub-modes ofoperation. For example, the instrument described in the patent, which istypical of other similar instruments, has a cutting mode, separable intoCUT and CUT/COAG sub-modes, and a coagulation mode, separable into HEMO,FULGURATE, and BIPOLAR sub-modes.

[0004] In a typical surgical setting using such an instrument, a surgeonmay first use a handpiece while the instrument is in its cutting mode toperform a desired cutting procedure and then desire to use the samehandpiece for coagulation of blood vessels while the instrument is inits coagulation mode. To this end the electrosurgical instrument has onits front panel push buttons or switches for activating internalcircuitry for switching the electrosurgical instrument from its cuttingto its coagulation mode or vice-versa. A current electrosurgicalinstrument contains a power-supply-controlled radio-frequency (RF)oscillator which generates RF currents typically in the megacycle rangeas high-frequency AC waves. For most cutting purposes, the AC waveformis fully filtered to produce an approximate DC waveform. For mostcoagulation purposes, the AC waveform is partially rectified (commonlyhalf-wave rectification) to produce the characteristic half-waverectified waveform. This is accomplished by switching in certainrectifier and filter components for the cutting mode, and switching incertain rectifier components for the coagulation mode. This is wellknown in the art and further description is unnecessary. Suffice to say,the switching action occurs inside the instrument when the front panelcontrols are activated by the surgeon.

[0005] To simplify mode selection by the surgeon, it is known to placeon the handpiece two finger-activated switches that can be connected byappropriate wiring to the electrosurgical instrument and wired inparallel with the front panel switches so that activation of either thefinger switches on the handpiece or the front panel switches will allowmode selection. This is similar to the connection and operation of afoot switch that can be used by the surgeon to activate and deactivatethe RF currents. More modern electrosurgical instruments, however, donot lend themselves to such a simple approach. The typical modernelectrosurgical instrument is computer-controlled, typically by amicrocontroller (μC); hence simple parallel-connected circuitry may notwork satisfactorily. Another problem is that the standard handpiece hasonly three terminals, one of which is dedicated to carrying thehigh-frequency or RF electrosurgical currents; hence, mode selectionmust be carried out in a safe manner using only two of the threeterminals.

[0006] A further complication in the use of such instruments is thevariety of surgical procedures to which the instrument can be applied,often with different electrodes. Each surgical procedure typicallyrequires not only a particular electrosurgical mode, such as cut orcut/coag, or hemo, but also may require a different set of modeconditions, such as the power setting and/or a different time durationof power application. With four therapeutic waveforms available incurrent Radiosurgery instruments and a wide power range, it is timeconsuming and memory dependent on the part of the surgeon and or staffto tune in the correct waveform and power settings for the particularprocedure to be carried out. Also there may have been occasions whenelectrosurgical injuries may have occurred due to incorrect waveformsettings and incorrect power settings for the chosen procedure.

SUMMARY OF INVENTION

[0007] The principal object of the invention is an intelligent selectionsystem for an electrosurgical instrument for use by the surgeon thatdepends primarily on the surgical procedure to be employed.

[0008] Another object of the invention is an intelligent selectionsystem for use by the surgeon that depends primarily on the surgicalprocedure to be employed and can be controlled by the handpiece chosenby the surgeon to perform the procedure.

[0009] A further object of the invention is a handpiece-controlledelectrosurgical instrument in which the choice of the handpiece controlsthe operating mode of the instrument and, preferably, also the modeconditions such as the power setting that is desired for carrying outthat particular procedure.

[0010] These objects are achieved in accordance with one aspect of theinvention by a novel what may be termed intelligent electrosurgicalsystem that incorporates multiple sets of stored or preset operatingmodes and conditions that allows the surgeon to select a particular setcustomized for the particular procedure to be carried out. So, forexample, if procedure A is to be carried out, then set A isautomatically selected, set A prescribing the electrosurgical mode ofoperation and one or more of the mode conditions specific to theselected procedure. Similarly, if procedure B is to be carried out, thenset B is automatically selected, set B prescribing the electrosurgicalmode of operation and one or more of the mode conditions specific to theselected procedure.

[0011] In principle, the selection system can be implemented byoperating a multiple-position switch or switches on the front panel ofthe instrument, each switch or switch position being associated withinone of tire stored sets of operating modes and conditions. However, inaccordance with a preferred feature of the invention, the selection isincorporated into the handpiece chosen by the surgeon. While it ispossible to build into the handpiece a fingerswitch for each of thestored sets of modes, this has the disadvantage that if the surgeonpresses the wrong fingerswitch, then the wrong operating mode for thecurrent procedure may be inadvertently selected. It is thereforepreferred in accordance with another feature of the invention to providea family of intelligent or smart handpieces, each dedicated to aparticular procedure.

[0012] In this preferred embodiment of the invention, each dedicatedhandpiece has incorporated in it means for generating a unique controlsignal that when processed by a computer in the electrosurgicalinstrument will automatically select that particular set of modeconditions specific to the procedure to which the handpiece isdedicated. There a number of different ways in which this feature can beimplemented and the description that follows will describe several ofthe ways.

[0013] It is also possible to go to the next step and control theappearance of the handpiece, for example, by color-coding or by itsshape, so that the surgeon understands that a specific colored or shapedhandpiece is associated with a specific procedure, which will furtherminimize the possibility of surgeon error.

[0014] As a further feature of the invention, instead of providinghandpieces which can typically receive one of several interchangeableelectrodes, the electrode appropriate for the specific procedure can bemolded into or otherwise fixed to the intelligent handpiece and made apermanent integral part of the handpiece further minimizing thepossibility of the surgeon choosing the wrong electrode for the specificprocedure.

[0015] In a preferred embodiment, a handpiece construction is similar tothe standard two-fingerswitch, three-terminal handpiece used heretoforeexcept that means are included in the handpiece such that, when a firstfingerswitch is activated, a first current level signal is outputted andwhen a second fingerswitch is activated, a second current level signalis outputted, both preferably from the same terminals. The means arechosen such that a μC in the instrument can distinguish the two currentlevels and activate the appropriate operating mode, for example, a cutmode for that particular procedure or a hemo mode for that particularprocedure.

[0016] In another preferred embodiment, a handpiece constructionincorporates memory means, preferably, a non-volatile memory chip, thatstores information representing a set of mode conditions which whentransmitted to the electrosurgical instrument automatically selects forthe instrument that particular set of instrument mode conditionsspecific to the procedure to which the handpiece is dedicated.

[0017] The various features of novelty which characterize the inventionare pointed out with particularity in the claims annexed to and forminga part of this disclosure. For a better understanding of the invention,its operating advantages and specific objects attained by its use,reference should be had to the accompanying drawings and descriptivematter in which there are illustrated and described the preferredembodiments of the invention, like reference numerals or letterssignifying the same or similar components.

SUMMARY OF THE DRAWINGS

[0018] In the drawings:

[0019]FIG. 1 is a schematic view of one form of electrosurgicalinstrument in accordance with the invention;

[0020]FIG. 2 is a circuit block diagram of one form of system circuitryfor the electrosurgical instrument of FIG. 1;

[0021]FIG. 3 is a flow chart illustrating how the system circuitry ofFIG. 2 can be software controlled and operated in accordance with theinvention;

[0022]FIG. 4 is a schematic view showing a handpiece connected to anelectrosurgical instrument in accordance with the invention;

[0023]FIG. 5 is a circuit schematic of one form of electrical circuitfor the handpiece of FIG. 4;

[0024]FIG. 6 illustrates schematically the interface connections in oneembodiment between the handpiece of FIG. 4 and the electrosurgicalinstrument;

[0025]FIG. 7 illustrates schematically the circuit connections inanother embodiment between the handpiece of FIG. 4 and theelectrosurgical instrument;

[0026]FIG. 8 is a partial perspective view of one form of 3-buttonhandpiece according to the invention;

[0027]FIG. 9 is a circuit schematic of one form of 4-button handpieceaccording to the invention;

[0028]FIG. 10 is a block diagram showing how the handpiece of FIG. 9 canbe interfaced to a microcontroller in the electrosurgical instrument;

[0029]FIG. 11 is a flow chart indicating how the electrosurgicalinstrument can be programmed to operate with smart handpieces accordingto the invention;

[0030]FIG. 12 shows a schematic block diagram of another embodiment ofan electrosurgical instrument according to the invention;

[0031]FIG. 13 is a flow chart illustrating one form of program foractivating the MANUAL or AUTO mode of the instrument.

DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS

[0032] One form of an electrosurgical instrument 10 according to theinvention is illustrated in FIG. 1. It comprises a system unit 12 havinga box-like housing comprising at the front a control panel 14 for theinstrument. The control panel includes touch switches 90 for selectingcutting or coagulation modes and touch switches 18 for controlling thepower output by increasing or decreasing in steps the power, asindicated by upper and lower digital displays showing all 8's. At thebottom are output female connectors 20, 22, 24 for plugging in,respectively, at the left, a fingerswitch-controlled unipolar handpiece26; at the center, a bipolar handpiece or forceps 28; and at the right asingle or split neutral plate 30. An on-off power switch 32 is at thefar right. The circuitry used to provide a fingerswitch-controlledunipolar handpiece may be of the type described in connection with thecontrol unit 50 of U.S. Pat. No. 4,463,759, whose contents are hereinincorporated by reference, which circuitry, is in this case incorporatedin the console unit 12. A connector (not shown) is provided at the sidefor receiving a conventional footswitch 34. Both the unipolar andbipolar handpieces can be simultaneously connected to the system unit 12and operated in any order without touching the system unit or thecontrol panel when the control panel has been preset or activated at thedesired powers by each of the handpieces. For example, if the surgeondetermines that s/he is going to perform a cutting procedure with aparticular electrode, then s/he can set the cutting mode power on theupper digital display to, say, 80 watts by the up/down buttons 18.(Typically, these units are designed to supply up to 100 watts of RFpower to either handpiece.) For coagulation with the bipolar handpieces/he may desire to use, say, 50 watts, which can also be set on thelower digital display by the up/down buttons 18. In this firstembodiment, the internal circuitry is controlled in a known manner sothat, when the fingerswitch unipolar handpiece is used, then RF powercan be supplied to die electrode in the unipolar handpiece when afingerswitch 36 on the handpiece 26 is depressed. However, when it isdesired to use the bipolar handpiece 28, then the footswitch 34 isdepressed, which then supplies RF power to the forceps of the bipolarhandpiece. This result is a consequence of software control such that,while the machine mode is selected such that the fingerswitches on theunipolar handpiece can be used to apply power to the electrode(footswitch mode non-selected), only the footswitch can be used to applypower to the bipolar handpiece. This prevents power selected for theunipolar handpiece to be applied to the bipolar handpiece,and-vice-versa. On the other hand, when it is not intended to use thebipolar handpiece and the footswitch mode is selected, then thefootswitch can be used to operate the unipolar handpiece.

[0033] One form of the RF circuitry to achieve the foregoing operationis illustrated in the block diagram of FIG. 2. The block 40 in the upperleft contains two independent conventional RF oscillators generating,preferably, RF oscillations at 8.0 and 3.42 MHz respectively. As will beexplained in greater detail below, the arrow 42 labeled CPU represents aselection signal generated by a conventional microcontroller undersoftware control and inputted into the block 40 to select for operationeither the 8.0 MHz oscillator or the 3.42-MHz oscillator. Bothoscillators are constantly on when the power switch is activated, andthe CPU selection 42 determines which of the third or fourth frequenciesare outputted to the divide-by-2 block 44, resulting in an RF carrier 46at either the first (4.0 MHz) or the second (1.71 MHz) frequency. Thatcarrier is then pre-amplified in block 48 and inputted to a conventionalmodulator stage 50. Also input to the modulator stage is a modulatingsignal 52 derived from a CPU selection signal 54 and a D/A converter 56.The modulations referred to are the different output waveforms used forthe known CUT, CUT/COAG, HEMO, and FULGURATE modes. These typically are:CUT-CW (full-wave rectified and filtered) output with maximum averagepower; CUT/COAG-full-wave rectified but unfiltered, deeply modulated, at37.5 or 75 Hz rate, envelope with approximately 70% average to peakpower ratio; HEMO-half-wave rectified and unfiltered, deeply modulated,at 37.5 or 75 Hz rate, envelope with approximately 35% average to peakpower ratio; FULGURATE (or Spark-Gap Wave)-deeply modulated, 3.6 KPPSrandom rate with approximately 20% average to peak power ratio.Selection of the bipolar mode will automatically select the HEMO mode.

[0034] The RF power generating circuitry may be of the well knowntube-type described in U.S. Pat. No. 3,730,188, whose contents areherein incorporated by reference, which is capable of generating afully-rectified, filtered RF current for cutting, a full-wave rectifiedcurrent for combining cutting and coagulation, and a half-wave rectifiedcurrent for coagulation. Alternatively, the RF, power generatingcircuitry can be of the well-known solid-slate type capable ofgenerating the same kinds of waveforms. The RF circuitry, as such, isnot part of the present invention, as such circuits are well-known inthe prior art. In this case, the RF circuitry provides two differentfrequencies of operation, a first high frequency in the range of 3.8-4.0MHz, and a second high frequency in the range of 1.7-2.0 MHz, which iseasily obtained by providing a known RF generator that provides a firstand second outputs at the first and second higher frequencies andproviding a simple known divide-by-two circuit for obtaining a secondoutput at one half of the first or second frequency. Both outputs can beseparately amplified and processed and made available at the console'soutput connectors depending on the switches activated. The presentinvention is not limited to the dual-frequency output operation.

[0035] After the modulated carrier has been generated at 58, it isprocessed through a standard driver 60, a transformer 62, and a poweramplifier 64 controlled by a bias signal and whose input is monitoredfor safety's sake by a power tester circuit 66 under control of the CPU.The power amplifier output 68 is inputted to a mode selection block 70under control of a signal from the CPU. The mode selection is made bythe user by activating the upper panel 72 by pressing switch 16 in theupper panel, or the lower panel 74 by pressing switch 16 in the lowerpanel. That selection, made in conjunction with the selection 42,directs the output RF energy along the upper branch 76 or the lowerbranch 78. Both branches contain an isolation transformer 80 and asensor 82 for operating indicators and preventing both branches frombeing activated at the same time. In other words, when the monopolarsensor 82 senses RF energy, the bipolar branch is disabled, and when thebipolar sensor 82 senses RF energy, the monopolar branch is disabled.The outputs 84, 86 shown at the right are directed to the connectors 20and 22, respectively.

[0036] In this embodiment, the instrument is software controlled withthe user supplying the switch inputs. One form of software control isillustrated by the flow chart depicted in FIG. 3. When the on-off switch32 is toggled on, the microcontroller (not shown) is placed in itsstandby condition represented by block 88. The first action by the useris to select cutting mode or coagulation mode by pressing the switch 90on the front panel, then pressing the upper or lower select switch 16which determines which of the cutting or coagulation modes will beoperable. If the coagulation mode is selected, the lower select switch16 is used to select unipolar (HEMO or FULGURATE) or bipolar mode. Thefingerswitch handpiece 26 operates exclusively of and independent fromthe footswitch mode selection 90 for all unipolar modes. This ensuresthat RF currents are available exclusively and at all times at one ofthe sockets 20, 22. If no such user action has occurred, tested at block92, the CPU returns 94 to its standby condition. If a selection has beenmade 96, control is passed to the test block 98, which tests whetherlower switch 16 has selected the bipolar mode. If yes 100, the circuitryto generate the 1.7 MHz carrier is selected at block 102, and controlpasses to the test block 104 which tests whether the footswitch 34 hasbeen pressed, which is the only way by which 1.7 MHz currents can bemade available at the bipolar handpiece socket 22. If no, the CPUreturns 106 to its standby mode; if yes 107, RF energy is supplied tothe bipolar handpiece socket 22.

[0037] If the bipolar mode was not selected at test block 98, then thecircuitry to generate the 4.0 MHz carrier is selected at block 108, andcontrol passes to a series of test blocks 110, 112, 114 which test.,respectively, whether the CUT, HEMO, or FULGURATE modes have beenselected by the user by means of upper and lower switches 16, which thenprovide the-RF energy at 4.0 MHz at the monopolar connector output 20.If also tine footswitch 34 was pressed, then the footswitch 34 cancontrol when the RF energy is supplied to the handpiece 26; otherwise,the fingerswitch 26 on the unipolar handpiece 26 controls the deliveryof RF energy to the patient.

[0038] In this operation using the instrument front panel switches, theground plate 30 is always attached to the patient, and the surgeon canperform any desired unipolar or bipolar electrosurgical procedure. Whenboth the unipolar and bipolar handpieces are plugged into the instrumentconsole 12, then the desired operating conditions for each can be presetas desired. Then whichever handpiece is picked up and operated by thesurgeon will automatically determine which is supplied with theappropriate RF currents. Thus, if the bipolar handpiece is selected andthe footswitch activated, the bipolar handpiece will be supplied with1.7 MHz currents at the power setting manually selected by the user. Onthe other hand, if the unipolar handpiece is selected and itsfingerswitch 36 activated, the unipolar handpiece will be supplied with4.0 MHz currents at the power setting manually selected by the user.This operates on a first-come, first-served basis, which thus allows thesurgeon to use the CUT mode for cutting with the unipolar handpiecefollowed with the bipolar ha handpiece for closing off any bleedersexposed during the cutting.

[0039] What has so far been described is the manual way of operating theinstrument with conventional handpieces. In accordance with die presentinvention, instead of or in addition to using the manual mode ofoperation, an automatic mode is incorporated that is determined by theprocedure to be performed by the surgeon or by the handpiece selected bythe surgeon for the procedure. Preferably, the desired mode is selectedby plugging an intelligent handpiece into the instrument. One example ofsuch a handpiece will now be described in connection with FIGS. 4-7.

[0040] In this example, the handpiece comprises a generally conventionalhandpiece 110, with certain changes added in accordance with theinvention, explained below, connected to a 3-line connector or terminal112 which in turn is connected by way of a multilane cable 114 to acontrol system 116 in turn connected to on a part of, as is more common,a conventional electrosurgical instrument 118 of the type illustrated inFIG. 1. The electrosurgical instrument 118 comprises an RF generatorwith the usual circuits to generate current waveforms in thehigh-frequency megacycle range, for example, 1-4 MHz, and also includesvarious circuit components to control the shape of the waveforms forvarious operating modes, including the cutting and coagulation modes asabove described. The selection can be made by means of push buttons orswitches on the control panel of the instrument. In the more modernelectrosurgical instruments, the control is usually exercised by way ofa computer, usually a μC, with the controls determining which inputs ofthe μC are activated, which controls which outputs of the μC areenabled, in turn in one embodiment switching in or out of thepower-supply-controlled RF circuit rectifying and filter components (notshown as well known in the art) for the different modes selected.

[0041] In this preferred embodiment, the handpiece 110 comprises apencil-type housing 111 on which is provided two fingerswitches 120, 122for mode selection. In addition, it contains a chuck or other holdingdevice 124 for receiving the shank of a conventional removableelectrosurgical electrode 126. The shank is typically of metal, as isthe chuck, which is connected by an electrical conductor 130 to one ofthe terminals of the connector 112. The two fingerswitches 120, 122 arealso connected to the other two of the three terminal on the connector112.

[0042]FIG. 5 shows the internal circuitry of the handpiece 110. Thechuck 124 and line 130 carry the RF currents within the handpiecehousing 111 to the electrode when inserted in the chuck 124. This usesthe bottom terminal of the connector 112. The upper two terminals areconnected inside of the housing 111 as shown to the two fingerswitches120, 122. A resistor 132 is also mounted inside the housing 111. As willbe observed, when switch 120 is closed, the circuit bypasses theresistor 132; however when instead switch 122 is closed, the circuitthrough the upper two terminal includes the resistor 132 in series.

[0043] As schematically indicated in one embodiment illustrated in FIG.6 for identifying the inputted control signal the top terminal isgrounded for safety's sake and together with file bottom terminalconnected to an isolation transformer 136 which in turn is coupled tothe RF oscillator. Tile center terminal is connected via a currentlimiting resistor 138 to a DC voltage source 140 which provides a DCcurrent to a DC amplifier 142 whose magnitude is determined by which ofthe two fingerswitches are activated. When fingerswitch 120 is pressed,which bypasses the resistor 132, a higher level of DC current is fed tothe amplifier 142. When fingerswitch 122 is pressed, which includes theresistor 132 in the circuit, a lower level of DC current is fed to theamplifier 142. The μC is adjusted to distinguish between the two DCcurrent levels and in a known way to activate one or more of its outputswhich will select the desired operating mode that has been associatedwith the corresponding fingerswitch. Alternatively, the output from theamplifier 142 can be inputted to a DC comparator to which a referencecurrent is supplied, with the comparator determining, as is well known,whether the input current is below or above the reference, with thecomparator outputting, say, a “1” when the output current exceeds thereference, or a “0” when the output current is below the reference. TheμC can then be set to respond to the digital “1” or “0” to select theoperating mode.

[0044] In the preferred embodiment, the left fingerswitch 120 is used toselect the cutting mode, and the right fingerswitch 122 is used toselect the coagulation mode.

[0045] As will be observed, by the simple expedient of adding one ormore small resistors 132 to the standard handpiece to change the DCcurrent level established depending upon which of the two fingerswitchesare activated, while continuing to use the standard three-terminalconnector, it is possible to provide a simple DC output from twoterminals which is easily interfaced to a standard μC to control theoperating mode of lie electrosurgical instrument. The use of a DCcircuit eliminates the possibility of noise or other interfering signalfrom the RF currents at the third terminal that can cause accidentalmode switching.

[0046]FIG. 7 illustrates another preferred embodiment in which the cutand coag waveforms are generated in a somewhat different manner. In thisembodiment, a conventional RF oscillator 150 generates a continuous wave(CW) output that is fed to a conventional mixer 152. The latter iscontrolled by a microcontroller 156. The microcontroller 156 in turnreceives a low-level control signal or a high-level control signal fromthe handpiece 110 depending upon whether fingerswitch 120 or 122 ispressed. The microcontroller 156 may be software controlled, and inresponse to the handpiece signal input causes the modulator to produceno output or a signal at a 100-120 Hz rate which is ON for approximatelyone-half the cycle and OFF for the other half. The mixer 152 thusoutputs, when no modulator signal is inputted, the unmodulated CW outputfor the cut mode; and when the described 100-120 Hz signal is inputted,the mixer outputs a deeply-modulated RF carrier envelope with an averageto peak ratio of about 50% for the coag mode.

[0047] In this second embodiment, the output waveform is no longerdependent upon the power supply. An AC control current can be used inplace of the DC current, at a voltage of about 5 volts at a frequency ofabout 300-500 KHz, which is below the megacycle range of the RF outputto minimize interference.

[0048] In a further preferred embodiment of the invention, the currentlevel controlling means is a simple impedance, preferably a resistor,mounted in the handpiece and connected to the two fingerswitches suchthat it is in or out of the circuit depending upon which fingerswitch isactivated.

[0049] Besides low power and low cost, the fingerswitch mode controllerof the invention is easily operable with relatively low frequency AC ordirect currents (DC). Tills is important because the control circuitrythat carries the two AC or DC levels of current is housed is the samepencil-type handpiece that includes the line carrying the RF AC currentswhich is a possible source of RF interference with such control systemsfor mode selection. For safety's sake it is important that no accidentalundesired switching between the two modes occurs while a surgicalprocedure is being carried out. In addition, the system of the inventionoffers the advantages of accessibility and versatility, providing thesurgeon all the benefits of fingerswitch selection of eitherelectrosurgical mode.

[0050] The preferred embodiment uses a 100 ohm resistance for the modeselection resistor 132. With an AC current established at the upper twoterminals of about 70 mA when the fingerswitch 120 is closed, wheninstead the fingerswitch 122 is closed, the introduction of the seriesresistor 132 reduces the DC current to about 3 mA. This difference issufficient to be detected and when amplified or digitized can be used tocontrol the μC. However, it will be apparent to those skilled in the artthat the choice of resistance depends upon a number of factors includingthe type of μC used and the circuit components between the μC and thehandpiece, and other resistance values would be appropriate with othercircuits and is deemed within the scope of the invention. The benefit ofthe 100 ohm resistor is that, as a small wattage component, it is verysmall and easily fitted within the pencil-like structure of the housing111, which typically has a diameter of about ½ inches or less, forexample ⅜ inches, and a length of about 2¾ inches. Also, the inventionis not limited to resistors as other small size impedances could besubstituted capable of sufficiently changing the DC or AC current levelupon activation of one or the other fingerswitch.

[0051] In the preferred mode of operation, the RF power is in afrequency range exceeding 1 MHz. 11.7-4 MHz being preferred. However,the invention is not so limited and other frequency rangesfor-electrosurgical procedures are also considered within the scope ofthe invention.

[0052] What has so far been described is how a novel construction of thehandpiece can be used to generate a control signal to operate a μC whichthen controls the electrosurgical instrument to provide the correct modeOf RF operating currents to the handpiece. It will be understood thatthe symbol for a microcomputer μC is also used herein to signify amicrocontroller, commercial embodiments of which both contain for allpractical purposes the same computing elements including a ROM to storea program in the usual way. In these embodiments, a first button of thehandpiece is used to select unipolar operation and a second button isused to select bipolar operation. The invention is not limited totwo-button handpieces but also includes handpieces with one or moreadditional buttons. FIG. 8 illustrates the internal construction of ahandpiece provided with 3 buttons and 2 internal impedances and thestandard 3-terminal output, and FIG. 9 is the schematic of a 4-buttonhandpiece with 3 internal impedances, an internal non-volatile memory,e.g., an EEPROM, and a 5-terminal output. The FIG. 8 view is with thehousing omitted to show one possible internal construction whichcomprises in front the electrode holder 158, three finger switches 162,164, 166, two resistors 168, 169, and a cable holder 170 at the rearwhich terminates in a 3-terminal connector (not shown). PC boards 172,173 can also be mounted below as shown if needed.

[0053]FIG. 9 illustrates one possible schematic for a 4-button handpieceSW1-SW4 with 3 impedances R1-R3 in the form of resistors. In thisembodiment, a 5-terminal connector 174 is provided to increase thenumber of control signals that can be accommodated, as well as provideconnections to an internal EEPROM 176 for reasons to be explained below.It is understood that the invention is not limited to separateconnections for the finger switches and the EEPROM. As is well known inthe μC used in watches, the same button or key can be used for differentfunctions by having the AC sense multiple button presses, and associatefor example function A with one key press and function B with two quickpresses of the same key, and the same approach can be used in theinvention but the illustrated arrangement is preferred.

[0054] A block diagram illustrating the interfacing arrangement of a μCto the handpiece is shown in FIG. 10. In this embodiment, the μC 178 isconnected via conventional optical isolation 179 to the handpiece 180.The microcontroller 178 can communicate through a serial protocol to theEEPROM 182 (electrically erasable read only memory) incorporated insidethe handpiece 180. Optical isolation is desirable to protect theprocessor 178 from RF noise generated while the instrument's output isactive. The memory 182 in the handpiece can be read from and written to(if a read/write memory is used) by the processor 178 to allow thehandpiece to store a variety of configuration and operationalinformation.

[0055] A further example of how the selected mode, power, and time canbe actually implemented iii the instrument is illustrated by the flowchart in FIG. 11. Recall that the handpiece need not be limited toremembering or setting modes and power levels but must cooperate withthe local electrosurgical instrument to provide the functions asdescribed above. It will work with the Surgitron IEC II (Dual Frequency)electrosurgical instrument manufactured by the Eltman company but isobviously not limited to use with that particular system so long as thecurrent system has been appropriately modified to include the necessaryprogrammed μC to provide the functions as described. Some of thosefunctions are illustrated in the flow chart of FIG. 11. The startingpoint is the initialization block 184. If no handpiece, sometimesreferred to for brevity herein as “probe”, has been connected to theinstrument or it is unconfigured 186, the program branches to block 187to check whether a probe has been connected. If the answer is no, theprogram loops back to block 187. If the answer is yes, the program fallsthrough to block 188 to check whether die system is configured. If theanswer is no, therein, under control of the program in, the systemcontroller 178 accesses the internal EEPROM 182, reads 189 the EEPROMsettings, and at block 190 then configures the instrument (system) tothe correct mode and condition settings. The program then returns toblock 187, proceeds then to block 188 and branches to the right to theblock 192 which allows operation including if desired display of theoperating parameters to the user based on the EEPROM settings.

[0056] In the read probe block 189, the μC receives an unambiguousindication of what buttons are, physically on the probe and what modesthey initiate. A probe could be configured to allow a unit to work onlyin one or certain modes, and could also be configured to allow theelectrosurgical unit to put out only certain ranges of power in eachallowed mode. In addition, the probe memory 182 could be used toimplement the number of uses or elapsed time of use functions. A newprobe might be set to 50 uses or 100 minutes Of use to retain itsreliability. When a probe has run out of time/uses it could be recharged(reprogrammed) or thrown away. The probe is typically factory configuredto define the above information. The instrument reads the probe data andconfigures itself. The hardware used to interface the handpiece to theinstrument can be the same as that described in connection with FIGS.1-7 above.

[0057] The mode and condition-setting functions can be incorporated inthe probe or handpiece as just described or in the electrosurgicalinstrument or in both. In the case of the electrosurgical instrument,there are a number of different ways in which a handpiece key press or 2key presses can select the mode and conditions of a particularprocedure. The simplest way is to incorporate in the instrument aconventional look-up table, that contains the mode and operatingconditions for a number of different procedures, with the look-up tableresponding to a particular control signal (key) from the handpiece tovector to a subroutine which, equivalent to the surgeon's activation ofthe front panel switches, automatically switches the electrosurgicalinstrument to the correct mode and sub-mode and automatically sets thepower to a specific value or to allow a specific range of values thatwill not harm the patient. A timer can also be included in theelectrosurgical instrument so that the ON time of the instrument doesnot exceed a maximum time for the application of electrosurgicalcurrents to the patient undergoing that procedure. As one example, ahandpiece can be provided that is tailored for surgical procedurescarried out with the instrument set at the cutting mode and the Cut orCut/Coag sub-mode. The handpiece has incorporated in it a known bladeelectrode. For many cutting procedures, a typical power setting fortissue incisions is, say, 10 Watt, and a typical cutting duration rarelyexceeds 10 sec. The handpiece tailored for cutting has a resistor of say40 ohms connected to finger switch-2, and a resistor of say 30 ohmsconnected to finger switch-3. So, when finger switch-2 is pressed, acontrol signal of, say, 20 mA is sent to the instrument housing the μCand when finger switch-3 is pressed, a control signal of 30 mA is sentto the instrument housing the μC. Referring now to FIG. 12, which showsa schematic block diagram of an electrosurgical instrument according tothe invention, inside the housing is a conventional analog-to-digital(A/D) converter 300 which converts the received control signals to adigital number representing a key to the look-up table. The digitalnumber generated by the A/D converter when receiving a 20 mA signal andthat generated when receiving a 30 mA signal are different and eachcorresponds to a different entry or key into the look-up table and thusa different subroutine is executed depending upon whether the controlsignal comes from the second or the third finger see itch. The keyoutputted from the A/D converter is inputted to the look-up table 302which, as illustrated below, could store three data items that areoutputted to the RF generator 304 of the instrument. The first 306 isthe mode-select signal which switches the RF generator to, say, the Cutmode. The second 308 is the sub-mode-select signal which switches the RFgenerator to, say, the Cut sub-mode. The third 310 is the power selectsignal which switches the RF generator to the desired power setting. Inthis particular case, assuming that finger switch-2 is associated with aCut sub-mode at 10 Watt, then the outputs from the look-up table switchthe instrument into the Cut sub-mode, and sets the power setting at 10Watt, and, of course, in the usual way the activation of the fingerswitch causes the μC to execute the program illustrated in FIG. 3resulting in the application of 4 MHz electrosurgical currents to theactive electrode mounted at the end of the handpiece. A similar actiontakes place when fingerswitch-3 is pressed except that the differentcontrol signal when converted to a different digital number correspondsto a different entry or key into the look-up table resulting inswitching of the instrument to the Cut/Coag sub-mode with a powersetting of say 15 Watt. If desired, the look-up table can alsoincorporate a data item representing a duration not to exceed a fixedamount.

[0058] The mode selection and power settings is a straight forwardimplementation using the principles and circuitry described inconnection with FIGS. 1-3. The look-up table is an example of a databaseas a set of records each including an identifying key to uniquelyidentify the record and with each record in the set representing anoperating condition of the instrument. In the relatively small databaseinvolved here, it can be implemented as an unordered list in which anyrecord is easily accessed by inputting an identifying key which thenoutputs the record. The key here is the control signal generated by aparticular key press or handpiece, converted to a digital number, andthe record outputted could be, for example, a digital word theindividual bits of which or combinations of bits represent a mode,sub-mode or mode condition (explained below). Alternatively, thedatabase can be implemented as a table of records indexed by identifyingkeys, either as a 1-dimensional table or as a list of records. In eithercase, the inputted key produces a unique output record. The specific wayof accomplishing outputting of records upon inputting of keys is notpart of the present invention and is well known in the art.

[0059] Assuming the outputted record is a 16 bit word stored in a freeregister in the μC, then the μC can easily be programmed to access thebits to select specific modes and conditions. For example, the first bitcan represent by a 0 the cutting mode and by a 1 the coagulation mode;the 2^(nd and) 3^(rd) bits can represent cut by 00 and cut/coag by 01 inthe cutting mode, and in the coagulation mode 0 as Hemo, 01 asfulgurate, and 10 as bipolar. The power setting can be represented bythe 4^(th), 5^(th), 6^(th), 7^(th), and 8^(th) bits. Five bits canrepresent 32 different power settings. Assuming a power range of 1-64watt, then 32 settings in that range separated by 2 watt intervals canbe defined by the five bits. If finer divisions are required, 6 bitswill define 64 different possible settings. Without a timer, then; evenan 8 bit word will suffice. If timer settings are required, with finerpower divisions, 7 bits of a 16 bit word will remain to define theduration settings which typically range from 1-50 sec. Similarly, bygoing to a 32 bit word, common in today's technology, then 16 bits willbe available to select other conditions. Possibilities include: 1) inseveral procedures, it is common to irrigate the tissue cut or ablated.These additional bits can The used to turn on and off an irrigation pumpsupplying fluid to a tube mounted on the handpiece; and 2) it is alsocommon to apply suction to the surgical site to remove undesirableplumes and odors. These additional bits can bee used to turn on and offa vacuum pump supplying suction to a tube mounted on the handpiece.

[0060] In the latter embodiment, the database was incorporated insidethe electrosurgical instrument and the access keys supplied by thecontrol signals inputted from the handpiece when specific keys arepressed. As a further alternative using two look-up tables, anon-volatile memory is provided in the handpiece (see FIG. 10) andstores in a lookup table in the memory 1-3 digital words whichrepresents the desired electrosurgical modes and conditions. The μC inthis case is located in the instrument. Assuming a 3-finger-buttonswitch handpiece, 3 different control signals can be generated by thehandpiece in response to pressing any one of the 3 buttons. Whenconverted to a digital number, the handpiece control signal can act asan identifying key for a simple look-up table in the instrument, inwhich case the single output from the instrument look-up table is anidentifying key for the handpiece lookup table. When the latter from theinstrument look-up table is returned via a multiplexed data line to thehandpiece look-up table, the handpiece look-up table will return on thesame data line in, a different time slot one of the 3 digital wordsstored in the handpiece look-up table. That returned word can beprocessed by the μC in the same manner as described above. In both ofthese embodiments, the handpiece becomes a dedicated or customizedhandpiece which generates a unique control signal from one or more ofits buttons which represents instrument modes and conditions for one ormore specific procedures, or generates a unique digital word when one ormore of its buttons are pressed which also represents instrument modesand conditions for one or more specific procedures. In other words, thehandpiece is factory-constructed or programmed to perform only certainprocedures, and each surgical specialty will therefore require a familyof several of these dedicated handpieces in order to perform severaldifferent procedures. This assures the surgeon that if he selects theright handpiece, then it is less likely that lie will cause inadvertentinjury to the patient. This can also be enhanced by color coding orshaping the handpieces differently, so, for example, the blue colored ormarked handpiece is specific to a cutting operation, and the red coloredor marked handpiece is specific to a coagulation procedure.

[0061] In several of the previous embodiments, the dedicated handpiececomprises one or more buttons operating finger-switches each of whichrepresents a set of mode conditions which when transmitted to theelectrosurgical instrument automatically selects for the instrument thatparticular set of instrument mode conditions specific to the procedureto which the handpiece is dedicated. However, it will also be understoodin accordance with another feature of the invention that the dedicatedhandpiece does not require any buttons at all to be able to inform theelectrosurgical instrument of the particular set of instrument modeconditions specific to the procedure to which the handpiece isdedicated. So, for example, by incorporating in the handpiece asillustrated in FIG. 9 memory means, preferably, a non-volatile memorychip, that stores one set of information representing instrument modeconditions specific to the procedure to which the handpiece isdedicated, their merely operating the instrument with that dedicatedhandpiece plugged in can easily be made to cause the handpiece to outputa control signal representing the selected mode condition set forcontrolling the instrument which can be processed by the electrosurgicalinstrument in the same manner as described above. In this handpieceembodiment with no buttons, since only one procedure is possible, it isconvenient to fix the electrode for that one procedure to the handpiece,as by molding it into the handpiece. This feature is also described andclaimed in at copending patent application, Ser. No. ______, filed______ (PAT 114); whose contents are herein incorporated by reference.

[0062] In the 4-button handpiece schematically illustrated in FIG. 9,the 4 buttons, SW1, SW2, SW3, SW4, are connected to a 5-pin connector174 which can be plugged into a system with a matching connector, or tothe system illustrated in FIG. 1 with an intervening adapter andcircuitry to allow three of the connector connections to be multiplexedto share the smaller number of connectors on the system panel. SW1 withno series resistor will produce a first control signal when pressed; SW2with series resistor R1 will produce a second control signal whenpressed; SW3 with series resistor R2 will produce a third control signalwhen pressed; and SW4 with series resistor R3 will produce a fourthcontrol signal when pressed. These signals are outputted to terminalconnections 2 and 3. The EEPROM 176 can be accessed via terminalconnections 4 and 5 and conventional multiplexing: Terminal 1 isreserved for receiving and applying the selected RF electrosurgicalcurrents from the system unit.

[0063] The table appearing below shows examples of how the controlhandpiece impedances can be arranged. In this case, each impedance isdedicated to a particular mode and a specific power level. For example,the impedance ZC00 is designated for the CUT mode with a power level of100 Watts. By impedance in this context it will be understood is meantan incorporated element in the handpiece that causes the latter tooutput a particular control signal for this particular mode and outputpower setting. Thus, the incorporated impedance represents acorresponding pre-set function or electrosurgical procedure. A doctormay select the handpiece with the corresponding pre-set function thatwill serve the purpose of the desired procedure. The listed impedancesand their designated modes and power levels are examples of how eachimpedance can be matched to its pre-set function. TABLE Misc. (forImpedance Waveform other items No. Waveform Mode Sub-Mode Power ifneeded) ZCOO CUTTING CUT 50 ZBCO CUTTING CVT/COAG 40 XNFO COAGULATIONHEMO 20 XSHO COAGULATION BIPOLAR 10

[0064] In this example, the letter Z can represent the CUTTING waveformmode; the letter X can represent the the COAGULATION waveform mode; thesecond letter the relevant sub-mode; the third and fourth lettersvarious conditions such as power or duration. Sometimes the durationvalue in the record can represent a maximum value. This simply meansthat when that value is inserted in a countdown tinier 312 (FIG. 12),the latter starts counting down when the RF electrosurgical currents aresupplied to the handpiece electrode and will automatically shut down theelectrosurgical currents when the timer reaches zero, as a safetyfeature. Of course, the physician can as usual stop the flow of currentsby simply releasing the handpiece button whenever s/he desires.

[0065] In principle, the number of impedances has no limit. It can be asmuch as required to meet the desired pre-set functions. That is to say,the number of handpieces provided in a family equals the number ofdesired pre-set functions. Many kinds of surgical procedures requiremany kinds of different functions. Many kinds of-different functionsrequire many kinds of handpieces. The number of impedance that can beused will be chosen to match as many of the handpiece functions asdesired. Each handpiece may have one or more buttons to activate Theelectrosurgical generator. The 3-button handpiece is one example of howa handpiece may control more than just one pre-set function. The smartelectrode handpiece may have as many button switches as required tocontrol the variety of pre-set functions by installing the correspondingimpedances into the smart handpiece.

[0066] The output from the smart handpiece derived from the impedance isan analog control whose value is determined by the value of theimpedance or sensor, which may be, for example, a resistor. The resistoranalog voltage may be converted in a conventional A/D converter to adigital number for the purposes taught above. However, the resistor isnot a unique selection. The sensor can be any passive and/or activeelement, that includes resistor, inductor, capacitor, transistor, andeven an integrated circuit.

[0067] The μC processes the received analog sensing signal/voltagethrough the A/D converter, and then matches the signal to a pre-setfunction. This can be done in the ways indicated above or in other ways.Besides the look-up table, a stored software program with a routinededicated to that predetermined-set function in die μC is anotherpreferred embodiment. When the program routine selected is executed, theμC can send out a digital signal to a digital-to-analog (D/A) converterto control an active circuit in the electrosurgical instrument togenerate the specified waveform and its power level. One way of doingthis has already been described above in connection with FIGS. 1-7. Insummary, in this embodiment, the impedance in the smart electrodehandpiece will output a control signal in the form of a differentpotential or voltage or current detected by a sensing circuit within theelectrosurgical generator. The voltage is the electrical signal touniform the μC to fetch the pre-set function from ROM or in the softwareprogram, and then to execute the function. The receiving circuit in theinstrument merely functions to read in the voltage or current changecaused by the impedance and pass it on to the A/D converter forsubsequent processing.

[0068] As described above, the table caw be a look-up table stored ina-ROM chip, or can be software routines in the μC. Each record orroutine represents each impedance which corresponds to a specificpre-set function. However, the pre-set functions are not limited to thelisted functions in the table. They can also include radio frequencyapplications, a temperature controller, timing duration, hertzstimulation ultrasonic levels, and other sorts of output signals.

[0069] It is preferred that the electrosurgical instrument contains“AUTO” and “MANUAL” modes. The electrosurgical instrument will selectthe pre-set function automatically when “AUTO” mode is selected.Otherwise, in “MANUAL” mode, the user gets the freedom to override theAUTO function and manually select a desired output waveform and itspower level. Also; if the user desires, s/he may program theelectrosurgical instrument to set or store this particular selectioninto the SAC memory.

[0070] It is preferred that the selected function be confirmed to thephysician after the selection has been made in the same way that happensupon MANUAL selection, namely, the instrument will display the pro-setfunction on the display panel to inform the user of its current mode andoutput setting.

[0071]FIG. 13 is, a block diagram illustrating one form of program foractivating the MANUAL or AUTO mode of the instrument. Theelectrosurgical unlit is at its initial state—standby mode 200—waitingfor instruction from its terminal connector connected to the selectedhandpiece. The electrosurgical Unit will sense from the control signalinputted by a handpiece button press whether AUTO or MANUAL has beenselected. For example, one button of the handpiece can be dedicated tothe MANUAL mode. Alternatively, if a look up table is employed, onerecord selected can have only a single data item which tells theinstrument that MANUAL mode has been selected. If it is MANUAL 202,then, the unit will adjust itself to the MANUAL mode 204 for furtherinstructions from its front panel. If AUTO has been selected, theprogram takes the left branch to block 206 to process further inputsfrom the handpiece. If an improper selection 208 is made, the programreturns to waiting block 206. When a selection has been made by acorrect button press, the program branches to the routine 210 that readsthe control signal and in block 212 compares the choices made againstthe values stored in the look-up table for validity. If, for example,too much power was indicated, the program branches to the left branch214 and then to a routine 216 that attempts to make an appropriateadjustment. If this is impossible, the program returns to the waitingblock 206 for another input. The improper input can be displayed to theuser at block 218. If the signal is OK the program takes the rightbranch which sets the correct instrument mode and sub-mode and prepares220 to deliver the selected electrosurgical currents to the electrodeattached to the handpiece. At the same time, the current modes and powersetting can be displayed to the user via block 222.

[0072] The signal confirmation or validity check made at block 212 ispresent to control and enable the pre-set output power block 220. Thisis an important safety feature of this invention. Double-clicking thepre-set output power ensures the quality and quantity of output powersignal to be delivered for the procedure. This will reduce or preventany problems from a component fault in the instrument or any uncertaintyof the output power. If the confirming signal is not received, theoutput power port will disable the power output.

[0073] Several examples to illustrate how specific procedures determinethe operating mode are, as follows:

[0074] I. The procedure for treating telangiectasia (the light facialspider veins located on the facial, eye or nose areas.). The correctwaveform for this procedure with the instrument described in thereferenced patent is the partially rectified waveform, i.e., theCoagulation mode and Hemo submode. The preferred power setting is 1 or ½watt. The preferred time is {fraction (1/20)} of a second. The preferredelectrode is a fine wire or needle.

[0075] II. Section Surgery-The correct waveform for this procedure withthe instrument described in the referenced patent is the fully rectifiedwaveform, i.e., the Cutting mode and Cut or Cut/Coag submode. Thepreferred power setting is about 10 watt. The preferred time is about 5second. The preferred electrode is a blade or needle.

[0076] III. Epistaxis-THe correct waveform for this procedure with theinstrument described in the referenced patent is the partially rectifiedwaveform, i.e., the Coagulation mode and Bipolar submode. The preferredpower setting is about 35 watt. The preferred time is about 20 second.The preferred electrode is a bipolar forceps.

[0077] IV. Tonsillar Fulguration-The correct waveform for this procedurewith the instrument described in the referenced patent is the spark gapthe waveform, i.e., the Coagulation mode and Fulgurate submode. Thepreferred power setting is-about 50 watt. The preferred time is about1-2 second. The preferred electrode is a ball electrode.

[0078] Note that there are many more procedures than those used asillustrative above using electrosurgery, and the above examples werechosen merely to illustrate that each physician would have to rememberthe appropriate instrument settings as well as the appropriateelectrodes and procedure duration times for each of these procedures ormake labels to secure this operational information. If the wrong currentor power and timing is used, it may result in burning of tissue,scarring, or excessive bleeding.

[0079] With the system of the invention using the intelligent handpieceand a proper insulated electrode, the physician simply plugs thehandpiece into the instrument and goes immediately to the procedure withthe confidence of precise, accurate waveform, power, and timingsettings. A wide range of additional settings can, if desired, be addedto those stored in the instrument.

[0080] Among the benefits of the invention are that it allows thehandpiece or probe to be tissue and procedure specific. By choosing thecorrect handpiece, it is ensured that it will provide the precisewaveform and power setting required by the chosen procedure. Inaddition, as another feature of the invention, the circuits will allowthe surgeon to override the settings determined by the handpiece byusing the selective buttons on the instrument panel. If preferred, anextra fingerswitch button can be added to the handpiece to provide thisoverride function.

[0081] Another advantage provided by the invention is that it enablesthe handpiece manufacturer to mold a procedure-specific electrode intothe handpiece thus guaranteeing the correct electrode tip, with thehandpiece dictating the waveform and power setting. In this case, theelectrode is fixed to the handpiece and the handpiece can only be usedwith that electrode in the procedure determined by its incorporatedsensor component.

[0082] It will also be understood that the invention is not limited tothe specific connectors shown. Also, different shapes of the housing arealso considered within the scope of the invention so long as the shapeallows for easy hand holding by the surgeon and easy operation withhis/her fingers of the two or more fingerswitches for mode selection. Inthe embodiments described, a control current is supplied to thehandpiece and the control signal outputted depends upon the nature ofthe impedance in the pressed-button circuit. As an alternative, it isalso, possible to include a small battery, such as a watch battery, inthe handpiece, the battery supplying the DC current to be modified bythe impedance in the circuit to create the control signal.

[0083] While the invention has been described in connection withpreferred embodiments, it will be understood that modifications thereofwithin the principles outlined above will be evident to those skilled inthe art and thus the invention is not limited to the preferredembodiments but is intended to encompass such modifications.

What is claimed is:
 1. An intelligent mode-selection system for anelectrosurgical instrument comprising: (a) an electrosurgical instrumentcapable of receiving a plurality of control signals for selecting anoperating mode, each of said control signals when received by theelectrosurgical instrument being capable of placing the instrument intoone of a plurality of operating electrosurgical modes, (b) a handpiecefor connection to the instrument and comprising multiple fingerswitchesand having an output (c) component means in the handpiece each connectedto one of the fingerswitches for generating, when supplied with currentand when a fingerswitch is activated, at the handpiece output one of aplurality of control signals, each of the control signals beingassociated with one of the plurality of operating eletctrosurgicalmodes, (d) means on the handpiece for holding an electrode fordelivering one of a plurality of RF electrosurgical currents eachrepresentative of one of the instrument's operating modes, (e) means onthe handpiece for outputting control signals to the electrosurgicalinstrument in response to the activation of the fingerswitches forselecting one of the operating modes, (f) means in said instrument inresponse to receipt of the control signals from the handpiece forsupplying to the electrode RF electrosurgical currents in the selectedmode.
 2. An intelligent selection system for an electrosurgicalinstrument as claimed in claim 1, further comprising a microcontrollerfor controlling the instrument and a storage system in theelectrosurgical instrument, said storage system being capable of storingpreset information representative of the plurality of operating modesand in response to any one of the control signals outputting controlinformation, said microcontroller in response to the control informationcontrolling the instrument such that the instrument is placed in theoperating mode associated with the activated fingerswitch.
 3. Anintelligent selection system for an electrosurgical instrument asclaimed in claim t, further comprising a microcontroller for controllingthe instrument in the electrosurgical instrument and software forcontrolling the microcontroller, said software being capable ofexecuting preset routines representative of the plurality of operatingmodes and in response to any one of the control signals controlling theoperation of the microcontroller such that that routine is executed thatplaces the instrument in the operating mode associated with theActivated fingerswitch.
 4. An intelligent selection system for anelectrosurgical instrument as claimed in claim 1, wherein each operatingmode produces a selected one of cut, cut/coag, or hemo electrosurgicalcurrents to the electrode.
 5. An intelligent selection system for anelectrossurgical instrument as claimed in claim 1, wherein eachoperating mode produces a selected one of a plurality of electrosurgicalcurrent output powers to the electrode.
 6. An intelligent selectionsystem for an electrosurgical instrument as claimed in claim 5 whereineach operating mode also produces a selected one of a plurality of timedurations of electrode currents to the electrode.
 7. An intelligentselection system for an electrosurgical instrument as claimed in claim1, further comprising a family of handpieces each comprising anelectrode integral with the handpiece, the electrode of each handpiecebeing customized for performing particular medical procedures, means insaid instrument in response to receipt of the control signals from eachof the handpieces of the family for supplying to the integral electrodeRF electrosurgical currents in a selected mode customized for theprocedure for which the handpiece is customized.
 8. An intelligentselection system for an electrosurgical instrument as claimed in claim1, wherein each of die handpieces are color-coded or shaped to representa particular procedure.
 9. An intelligent selection system for anelectrosurgical instrument as claimed in claim 1, further comprisingmeans interconnecting the handpiece and instrument for supplying acontrol current to the fingerswitches.
 10. An intelligent selectionsystem for an electrosurgical instrument comprising: (a) anelectrosurgical instrument in response to one of a plurality of controlsignals for generating a selected one of a plurality of operatingelectrosurgical modes, each of the operating modes being associated withone of the control signals, (b) a handpiece for connection to theinstrument and comprising multiple fingerswitches, (c) differentcomponent means in the handpiece each connected to one of diefingerswitches. (d) means interconnecting the handpiece and instrumentfor supplying a control current to the fingerswitches, (e) means in thehandpiece connected to each of the component means for generatingdifferent control signals when supplied with the control current, (f)means on the handpiece for receiving and holding an electrode fordelivering one of a plurality of RF electrosurgical currents eachrepresenting one of the operating modes, (g) means on the handpiece foroutputting control signals to the electrosurgical instrument in responseto the activation of the fingerswitches, (h) means in said instrument inresponse to receipt of the control signals from the handpiece supply tothe electrode RF electrosurgical currents in the selected mode.
 11. Ahandpiece according to claim 10, further comprising an electricalconnector comprising terminals and connected at a side of the housing,the different control signals being available at the same connectorterminal.
 12. A handpiece according to claim 11, wherein the electricalconnector comprises therein terminals, one of which is connected to theelectrode and the other two of which are connected to thefingerswitches.
 13. A handpiece according to claim 10, wherein thecontrol currents are DC currents.
 14. A handpiece according to claim 10,wherein the control currents are AC currents all a lower frequency thanthat of the RF electrosurgical currents.
 15. A handpiece according toclaim 10, wherein the different component means comprises smallimpedances.
 16. A handpiece for connection to electrosurgical apparatusand comprising fingerswitches for selectively providing cutting mode orcoagulation mode electrosurgical currents from the electrosurgicalapparatus to an electrode connected to the handpiece, said handpiececomprising: (a) a pencil-like housing, (b) at least first and secondfingerswitches on the housing, (c) means on the housing for receivingand holding an electrode for delivering RF electirosurgical currents,(d) means connected to the housing for supplying a control DC or ACcurrent to the fingerswitches, (e) means connecting the fingerswitchessuch that when the first fingerswitch is activated a first DC or ACcurrent level is established and when the second fingerswitch isactivated a second DC or AC current level is established, (f) said firstand second DC or AC current levels being usable to select, respectively,first and second operating modes of the electrosurgical apparatus.
 17. Ahandpiece according to claim 16, further comprising an electricalconnector comprising three terminals and connected at a side of thehousing, one of the three terminal being connected to the electrode andthe other two of the three terminals being connected to thefingerswitches, the first and second current levels being available atthe same connector terminal.
 18. A handpiece according to claim 16,wherein the handpiece comprises 3 finger switches.
 19. A handpieceaccording to claim 16, further comprising an electrode fixed to thehandpiece the electrode being associated with the selected operatingmode.
 20. A handpiece according to claim 19, wherein the RFelectrosurgical currents are in the megacycle range, and the controlcurrent is a DC or AC current in the kilocycle or lower range, and theelectrode is molded to the handpiece.
 21. A handpiece according to,claim 16, further comprising a non-volatile read or read/write memory inthe handpiece, said memory storing data items representing operatingmodes of the electrosurgical apparatus.
 22. A procedure-specifichandpiece for connection to electrosurgical apparatus for providing oneof cutting mode or coagulation mode electrosurgical currents from theelectrosurgical apparatus to an electrode connected to the handpiece,said handpiece comprising: (a) a pencil-like housing, (b) means on thehousing for receiving and holding an electrode for delivering RFelectrosurgical currents, (c) means in the handpiece for providing acontrol signal to the electrosurgical apparatus when activated, (d) saidcontrol signal representing for the electrosurgical apparatus operatingmode information associated with the specific procedure and usable bythe electrosurgical apparatus to select an operating mode specific tothe procedure.
 23. A handpiece according to claim 22, further comprisingan electrode fixed to the handpiece, the electrode being associated withthe specific procedure.
 24. A handpiece according to claim 23, whereinthe RF electrosurgical currents are in the megacycle range, and theelectrode is molded to the handpiece.
 25. A handpiece according to claim22, further comprising a non-volatile read or read/write memory in thehandpiece, said memory storing data items representing an operating modeof the electrosurgical apparatus specific to the procedure.
 26. Incombination: a) an electrosurgical apparatus comprising amicrocontroller and being capable of being switched via themicrocontroller from a cutting mode to a coagulation mode and vice versaupon the inputting of mode selection signals to the microcontroller,said electrosurgical apparatus when in the cutting mode generating RFelectrosurgical currents capable of performing a cutting operation whenapplied via an electrosurgical electrode and when in the coagulationmode generating RF electrosurgical currents capable of performing acoagulation operation when applied via the electrosurgical electrode, b)a handpiece for connection to the electrosurgical apparatus andcomprising fingerswitches for selectively providing cutting mode orcoagulation mode electrosurgical currents from the electrosurgicalapparatus to an electrode connected to the handpiece, said handpiececomprising: i) a housing, (ii) at least first and second fingerswitcheson the housing, (iii) means on the housing for receiving and holding anelectrode for delivering RF electrosurgical currents, (iv) meansconnected to the housing for supplying a control current to thefingerswitches, (v) means connecting the fingerswitches such that whenthe first fingerswitch is activated a first current level is establishedand when the second fingerswitch is activated a second current level isestablished, c) said first and second current levels serving as thecontrol signals and being usable be; the microcontroller to select anoperating mode of the electrosurgical apparatus.
 27. The combinationaccording to claim 26, wherein the electrosurgical apparatus comprises adatabase or look-up table connected to the microcontroller, the controlsignal representing a key to one of plural records in the database orlook-up table, each of the records representing an operating mode of theelectrosurgical apparatus.
 28. The combination according to claim 26,wherein the means of claim element b)(v) comprises a small impedance.29. The combination according to claim 26, further comprising anon-volatile memory in the handpiece and accessible from themicrocontroller.
 30. The combination according to claim 28, wherein thethe small impedance has a value of about 100 ohms.
 31. The combinationaccording to claim 26, wherein the RF electrosurgical currents are inthe megacycle range, and the control current is an AC current in thekilocycle or lower range.